Outline

Introduction: Breast cancer is the leading malignancy in females regarding incidence and mortality. Some therapeutic regiments are highly aggressive and may not only have temporary undesirable side effects, but may imply long lasting impairments. Therefore, besides clinical and demographic factors, medical care may have an important and prolonging impact on psychological well being and health related quality of life (QoL) of breast cancer patients.

Materials and Methods: Eligible study participants (females, ICD-10 C50, 18-85 years, residence in Schleswig-Holstein, announcement by name) were identified in the epidemiological population based cancer registry of Schleswig-Holstein and received a postal questionnaire. Our study aimed at determing medical care and quality of life (EORTC QLQ-C30, -BR23) in female breast cancer patients from Schleswig-Holstein (Germany).

Results: In the state wide cancer registry 2,366 breast cancer patients meeting the (study) inclusion criteria were registered. Of those 81.4% gave written consent and sent back a completed questionnaire (18.2 + 7.16 months after initial diagnosis).

Mean age at diagnosis was 58.8 + 11.3 years. Most patients had small (T1 55.5%) tumours (T2 35.9%). The total sample had a mean global health status and overall QoL score of 65.5 + 22.4. In the QLQ-C30 the highest disease burden was measured regarding ‘role functioning’ and ‘insomnia’ (QLQ-BR23: ‘sexual functioning’ and ‘hair loss’).

A binary logistic regression model was used to identify risk factors of low quality of life. However, living in an urban environment, a higher social status, and attendance to regular aftercare were associated with a lower risk, while increasing age, T-category of 2 or higher, known progression of the disease, complications due to therapy, attendance to a (inpatient) rehabilitation, and being interested in self-help groups indicated a higher risk of an overall low global health status (QoL score beneath the median of 66.7).

Discussion / Conclusion: 18 months after initial diagnosis the overall health related QoL in German female breast cancer survivors was comparable to the age adjusted female general population (65.4). As expected, factors that were related to perceived complications due to the therapy raised the risk for a low QoL. It is of interest, that attendance to a rehabilitation and interest in self-help groups independently predicted an increased risk for a low quality of life.